Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV

Han, Win Min and Law, Matthew G. and Choi, Jun Yong and Ditangco, Rossana and Kumarasamy, Nagalingeswaran and Chaiwarith, Romanee and Ly, Penh Sun and Khusuwan, Suwimon and Merati, Tuti Parwati and Do, Cuong Duy and Yunihastuti, Evy and Azwa, Iskandar and Lee, Man-Po and Pham, Thach Ngoc and Chan, Yu-Jiun and Kiertiburanakul, Sasisopin and Ng, Oon Tek and Tanuma, Junko and Pujari, Sanjay and Zhang, Fujie and Gani, Yasmin and Mave, Vidya and Ross, Jeremy and Avihingsanon, Anchalee and Datab, Treat Asia Hiv Observational (2022) Weight changes, metabolic syndrome and all-cause mortality among Asian adults living with HIV. HIV Medicine, 23 (3). pp. 274-286. ISSN 1464-2662, DOI https://doi.org/10.1111/hiv.13211.

Full text not available from this repository.


Objectives We investigated weight changes following antiretroviral therapy (ART) initiation, the development of metabolic syndrome (MetS) and its association with all-cause mortality among Asian adults living with HIV. Methods Participants enrolled in a regional Asian HIV-infected cohort with weight and height measurements at ART initiation were eligible for inclusion in the analysis. Factors associated with weight changes and incident MetS (according to the International Diabetic Federation (IDF) definition) were analysed using linear mixed models and Cox regression, respectively. Competing-risk regression models were used to investigate the association of MetS with all-cause mortality. Results Among 4931 people living with HIV (PLWH), 66% were male. At ART initiation, the median age was 34 interquartile range (IQR) 29-41] years, and the median (IQR) weight and body mass index (BMI) were 55 (48-63) kg and 20.5 (18.4-22.9) kg/m(2), respectively. At 1, 2 and 3 years of ART, overall mean (+/- standard deviation) weight gain was 2.2 (+/- 5.3), 3.0 (+/- 6.2) and 3.7 (+/- 6.5) kg, respectively. Participants with baseline CD4 count <= 200 cells/mu L weight difference (diff) = 2.2 kg; 95% confidence interval (CI) 1.9-2.5 kg] and baseline HIV RNA >= 100 000 HIV-1 RNA copies/mL (diff = 0.6 kg; 95% CI 0.2-1.0 kg), and those starting with integrase strand transfer inhibitor (INSTI)-based ART (diff = 2.1 kg; 95% CI 0.7-3.5 kg vs. nonnucleoside reverse transcriptase inhibitors) had greater weight gain. After exclusion of those with abnormal baseline levels of MetS components, 295/3503 had incident MetS 1.18 (95% CI 1.05-1.32)/100 person-years (PY)]. The mortality rate was 0.7 (95% CI 0.6-0.8)/100 PY. MetS was not significantly associated with all-cause mortality in the adjusted model (P = 0.236). Conclusions Weight gain after ART initiation was significantly higher among those initiating ART with lower CD4 count, higher HIV RNA and an INSTI-based regimen after controlling for baseline BMI. Greater efforts to identify and manage MetS among PLWH are needed.

Item Type: Article
Funders: Australian Government, Department of Health & Ageing, Fogarty International Center, as part of the International Epidemiology Databases to Evaluate AIDS (IeDEA) [Grant No: U01AI069907], United States Department of Health & Human Services, National Institutes of Health (NIH) - USA, NIH National Institute of Allergy & Infectious Diseases (NIAID), NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), NIH National Cancer Institute (NCI), NIH National Institute of Mental Health (NIMH), NIH National Institute on Drug Abuse (NIDA), European Commission, NIH National Heart Lung & Blood Institute (NHLBI), NIH National Institute on Alcohol Abuse & Alcoholism (NIAAA), NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
Uncontrolled Keywords: All-cause mortality; Asian people living with HIV; HIV; AIDS; Metabolic syndrome; Weight gain
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 20 Jul 2022 02:43
Last Modified: 20 Jul 2022 02:43
URI: http://eprints.um.edu.my/id/eprint/33687

Actions (login required)

View Item View Item